The Watermark at San Jose

Type of visit: Case Management - Deficiencies

On 05/05/2026, LPA Maria (Mita) Partoza, conducted an unannounced case management visit to address the deficiency that was observed on 09/12/2026, during a complaint investigation. LPA met with current executive director/administrator Jolie Higgins and stated the purpose of the visit. Based on observations and interviews, during the initial inspection conducted on 09/12/25, LPA observed ice accumulation on the freezer floor creating a slippery surface, indications that maintenance of the freezer unit was needed. Photographs were taken at the time of observation. LPA observed used rags on the food preparation area and an open trash bin. LPA checked and observed that the refrigerator temperature was at 50 degrees Fahrenheit, which exceeds the required range for safe food storage. The freezer temperature was measured at 0 degrees Fahrenheit, which is within regulatory range. LPA interviewed 2 kitchen staff (KS), 1 out of 2 staff stated that there was a call out and had to pull a double shift. 1 out of 2 staff stated, 2 people work in the kitchen. **2 kitchen staff (KS1 and KS2)** During the follow-up inspection on 11/05/2025, 02/24/26 and today's visit 04/16/2026, LPA observed the refrigerator and freezer within appropriate temperature ranges, floors free of debris, no safety hazards, trash stored in a designated outdoor area not conducive to pest activity, and kitchen access are limited to kitchen staff. Adequate staffing was observed. The conditions observed on 09/12/25 were not observed during the follow-up inspection on 11/05/2025, 02/24/2026 and during today's 04/17/2026. page 1 of 2 On 05/05/2026, LPA conducted additional interviews with kitchen staff (KS3 and KS4) who stated that they clean the kitchen floor. The trash bins are washed by the dishwashers who takes out the garbage at least once or two times a day or as necessary and as needed, if there are spills observed under the bins when the liners are taken out the kitchen staff (dishwashers) washes and sanitizes the bins right away. The used rags are put in the green bin outside of the kitchen door and trash are dumped in the dumpster. The freezer have been addressed and they regularly clean the freezer to remove the ice accumulations. The freezer maintenance person have checked and put new seals on the freezer to ensure that no ice is seeps through the door and cause a slippery floor. The temperature of the freezer is now at 40 degree F. Repairs to the refrigerator and freezer was addressed in November of 2025, and January of 2026, to ensure food safety. A technical assistance was provided to the current Executive Director/Administrator (ED/ADM) Jolie Higgins and to Executive Chef Cindy Padilla to monitor the temperature of the refrigerator and freezer according to prior observations. No deficiencies were cited during today's visit and a copy of the report was provided to ED/ADM Jolie Higgins.the state’s words, verbatim · CDSS document, May 5, 2026

Type of visit: Case Management - Other

On 05/05/2026, LPA Maria (Mita) Partoza, conducted an unannounced visit to amend the finding of the complaint investigation that was filed with the department on 09/08/2025. LPA met with Executive Director/Administrator (ED/ADM) Jolie Higgins The findings were delivered on 04/17/2026. However one of the allegations (allegation 4) was found to be unsubstantiated due to additional information that was received after the findings was completed and findings delivered to the facility on 04/17/2026. This case management is being created to capture the time and visit that LPA Partoza amended the report of complaint number 26-AS-20250908150102 and delivered the report. No deficiencies were cited during today's visit and a copy of the report was provided to Executive Director/Administrator Jolie Higgins.the state’s words, verbatim · CDSS document, May 5, 2026

Type of visit: Case Management - Other

Licensing Program Analysts (LPA) Marcela Yanez arrived unannounced to conduct a case management – incident visit. LPA met with Executive Director, Jolie Higgins. The purpose of the visit is to follow-up with a SOC341 received in the department on 04/20/26 regarding a sexual assault between R1 and R2. On 04/18/26 R1's private caregiver who had worked on 04/17/26 till 8 PM, arrived at facility at 8 AM and had observed a pair of slippers that did not belong to R1 in his/her room. R1's responsible party was informed and stated R1 might have been sexually assaulted because of R2's slippers were in R1's room. Local law enforcement was involved. LPA toured R1 and R2 bedrooms and did observe R1s door to automatically lock when it closes. During visit LPA interviewed Executive Director, Memory Care Director and 4 Staff Caregivers. LPA interviewed 2 residents. LPA obtained 2 resident physicians report, appraisal needs and services, identification/emergency contact information, Police Report number, R1s Advance Health Care Directive, and email communication. No deficiencies were cited per California Code of Regulations, Title 22. This report was reviewed with Executive Director, Jolie Higgins and a copy of the report was provided.the state’s words, verbatim · CDSS document, Apr 27, 2026

Allegation investigated: A3. Facility staff did not respond to call buttons in a timely manner A4. Facility staff did not ensure the kitchen is kept sanitary ***amended and transferred to LIC 9099A due to additional information received***

***On 5/5/2026. LPA Maria (Mita) Partoza, AMENDED the report due to additional information received for allegation A4*** Licensing Program Analyst (LPA) Maria (Mita) Partoza, conducted an unannounced visit to deliver the findings of the complaint received by the Department and met with current Executive Director/Administrator (ED/ADM) Jolie Higgins. LPA stated the purpose of the visit. On 09/08/2025, the Department received a complaint with the above allegations out of 6. The Department conducted initial investigations on 09/12/2025, 11/05/2025, and 02/24/2026. Allegation 3: Facility staff did not respond to call buttons in a timely manner. Based on interviews, on 09/12/25, witness 1 (W1) reported that resident 2 (R2) described delayed responses to pendant calls, approximately 3 weeks prior to 09/09/25, when resident 1 (R1) required assistance due to vomiting. On 11/05/25, LPA conducted an interview with R2 who stated that responses to call buttons often took one hour or more. page 1 Substantiated On 01/14/26, LPA interviewed staff S1, S3, S4 who stated that the typically response times of are approximately 15 to 20 minutes but stated delays may occur when staff are assisting other residents or during periods of high workload. Based on record review of pendant call logs for R1 from 08/01/25 through 12/31/25 there were 316 documented activations. Of those, 61 calls had response times ranging from 21.2 minutes to 67.8 minutes, with the longest recorded response time of 67.8 minutes on 08/07/25. Although delayed responses were not directly observed during the investigation, the facility’s records document multiple instances of extended response times. Allegation 4: Facility staff did not ensure the kitchen is kept sanitary - ***AMENDED - DUE TO ADDITIONAL INFORMATION received see LIC 9099A.*** Based on observations and interviews, during the initial inspection conducted on 09/12/25, LPA observed conditions in the kitchen that were not maintained in a clean and safe manner. LPA observed ice accumulation on the freezer floor creating a slippery surface, indications that maintenance of the freezer unit was needed. Photographs were taken at the time of observation. LPA observed used rags on the food preparation area and an open trash bin. LPA checked and observed that the refrigerator temperature was at 50 degrees Fahrenheit, which exceeds the required range for safe food storage. The freezer temperature was measured at 0 degrees Fahrenheit, which is within regulatory range. LPA interviewed 2 kitchen staff (KS), 1 out of 2 staff stated that there was a call out and had to pull a double shift. 1 out of 2 staff stated, 2 people work in the kitchen. **2 kitchen staff (KS1 and KS2)** On 01/14/26, LPA interviewed staff S1, S2, S3, S4 stated that caregivers are not permitted in the kitchen and did not report direct observations regarding kitchen sanitation conditions. page 2 Allegation 2: Facility staff left resident in a soiled diaper overnight Based on interviews, on 09/12/25, witness 1 (W1) reported that resident 2 (R2) stated, that resident 1 (R1) was left in a soiled brief for several hours, approximately 3 months prior. On 11/05/25, R2 reported one incident involving a soiled brief for R1, and this occurred approximately three months ago. On 01/14/26, staff 1 (S1) and staff 4 (S4) stated they had not observed R1 left in a soiled brief overnight. S4 reported that R1 was changed multiple times during night shifts. Staff 3 (S3) stated residents are checked every two hours and, when possible, it was more frequently for R1, but stated that residents may delay activating their call pendant or decline assistance. ***Allegation 4: Facility staff did not ensure the kitchen is kept sanitary - transferred from LIC 9099C due to new information received*** On 11/05/25, Former ED/ADM stated that the maggots were seen in the garbage outside of the facility not inside the kitchen. This happened when there were delays when the garbage was not picked-up on time by the garbage truck. On 01/14/26 LPA interviewed resident 2 (R2) who stated that he/she was told by 2 staff (caregivers) that maggots were seen on the kitchen floor while they were taking the garbage out, R2 does not remember the names of the staff and did not see the maggots personally. On 5/5/26 LPA interviewed 2 kitchen staff (KS3 & KS4). KS3 & KS4 stated no other staff are allowed in the kitchen, except kitchen staff who cleans and take away the garbage. KS3 & KS4 did not observe maggots on the floor since they started working at the facility for over a year.*** Allegation 5: Facility staff did not deliver food in a timely manner Based on interviews, on 09/12/25, W1 reported hearing concerns from R2 regarding meal delivery; however, no specific details or dates were provided. On 11/05/25, R2 reported one instance in which a meal delivery took more than one hour but could not recall the date. On 01/14/26, S3 recalled one similar incident but did not provide a specific date. S2 reported that typical food preparation and delivery time is approximately 15 to 20 minutes, with a 5 minute longer wait times for special orders, and stated that no complaints had been received. Allegation 6: Facility does not have sufficient staff Based on interviews and record reviews, 09/12/2025, W1 reported that the facility appeared disorganized but did not provide specific information regarding staffing levels. On 11/05/25, R2 reported high staff turnover. On 01/14/26, S1 and S4 stated staffing levels were sufficient. S3 stated that while response times may be delayed during high workload periods, required checks are conducted every two hours, with occasional delays of approximately 30 minutes. Based on record review of the facility's LIC 500 (Personnel Summary Report) the facility has adequate staffing and is in process of hiring more people. Based on interview, document reviews and observation; although the allegations may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore the allegations are unsubstantiated. No deficiencies were cited for the above allegations per CCR Title 22. An exit interview was conducted with ED/ADM Jolie Higgins and a copy of the report was provided. page 5 end of report During the follow-up inspection on 11/05/2025, 02/24/26 and today's visit 04/16/2026, LPA observed the refrigerator and freezer within appropriate temperature ranges, floors free of debris, no safety hazards, trash stored in a designated outdoor area not conducive to pest activity, and kitchen access are limited to kitchen staff. Adequate staffing was observed. The conditions observed on 09/12/25 were not observed during the follow-up inspection on 11/05/2025, 02/24/2026 and during today's 04/17/2026. Based on LPAs observations and interviews which were conducted and record review(s), the preponderance of evidence standard has been met, therefore the above allegation 3 and 4 are found to be SUBSTANTIATED. ***Amended - Allegation 4 (A4) due to additional information received, A4 is unsubstantiated, see LIC 9099A.*** California Code of Regulations (CCR) Title 22, Division 6, Chapter 8, Section 87468.2 Personal Rights and 87555(b)(27) – Food Service, are being cited on the attached LIC 9099D. ***Amended LIC 9099D for 87555(b)(27) is removed due to unsubstantiated findings based on the additional information received.*** An exit interview was conducted with Executive Director/Administrator Jolie Higgins and copy of the report and appeals rights were provided. See LIC 9099 A for the continuation of the report. page 3the state’s words, verbatim · CDSS document, Apr 17, 2026 · control 26-AS-20250908150102

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87468.2(a)(4) · Plan of correction due date: Apr 18, 2026

87468.2 Personal Rights (a) ...residents … shall have all of the following personal rights: … (4) To care, supervision, and services that meet their individual needs and are delivered by staff .... This requirement is not met as evidenced by: Based on record review, staff did not, respond timely to request for assistance. R1’s call log documented 316 activations (08/01/25–12/31/25), including 61 calls with response times up to 67.8 minutes, which poses a immediate health safety & personal rights risk to persons in care.the state’s words, verbatim · CDSS document, Apr 17, 2026

Plan of correction: ED/ADM stated that he/she will submit a written plan of correction to address the call light by administering in-service training with Assisted Living Staff and the will submit proof of correction by 4/22/2026

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87555(b)(27) · Plan of correction due date: Apr 18, 2026

87555(b)(27) – General Food Service Requirements (b) The following food service requirements shall apply: (27) All kitchen areas shall be kept clean and free of litter... This requirement is not met as evidenced by: *removed due to addt'l info*** Based on observation, the facility did not maintain the kitchen in accordance with regulatory requirement. On 09/12/25, LPA observed ice accumulation, food debris, refrigerator temperature of 50°F. which poses an immediate health, safety & personal rights risk to residents in care.the state’s words, verbatim · CDSS document, Apr 17, 2026

Plan of correction: ED/ADM stated he/she will submit a written plan of correction to address the kitchen maintenance and will submit the plan of correction by the POC dute date of 04/18/2026. *** CITATION REMOVED DUE TO ADDITONAL INFORMATION RECEIVED*** ***citation removed due to additional information received.***

Allegation investigated: Staff are not following a resident's hospice care plan. Staff are not responding to resident's call button. Staff left a resident in a soiled diaper.

Licensing Program Analyst (LPA) Steve Chang conducted an unannounced investigation visit to deliver the investigation findings and met with Executive Director (ED) Jolie Higgins. On 01/09/2026, the Department received a complaint with the above 3 allegations. On 01/16/2026, the Department conducted an initial investigation visit. LPA interviewed 4 staff, 10 residents, and 2 families of resident. LPA requested resident R1's physician report and care plans. Continue on LIC9099-C. Page 1 of 4. Unfounded Staff are not following a resident's hospice care plan: The allegation is that the facility staff did not provide shower service to resident R1, did not reposition R1, and did not provide catheter care service to R1. On 01/16/2026, LPA interviewed Assisted Living Director (ALD). ALD stated resident R1 uses external catheter and it does not need nurse to change external catheter or empty the catheter bag. ALD stated Med Tech, caregivers, and resident's family member are allowed to provide external catheter care to resident. ALD stated R1's family (FM) requested to do R1's external catheter care. ALD stated R1 needs shower/bath 2 times per week and R1's hospice care agency conducts the shower service for R1. ALD stated FM repositions R1 every 4 hours and the facility just provides reminder and assistance for R1's reposition. ALD stated FM requested the facility to provide "minimal" service to R1, and FM and R1's spouse (FM1) can provide care to R1 because FM is most of time in R1's room and FM1 is R1's roommate. ALD stated he/she is unsure if FM has financial concern and requested the facility to provide minimal service to R1. LPA interviewed Health and Wellness Director (HWD). HWD stated R1 uses external catheter and it does not need nurse to do the external catheter care. HWD provided R1's care plan to show that R1's external catheter care is conducted by FM, R1's showers is conducted by R1's hospice care agency, and FM conducted the reposition for R1 every 4 hours and the facility staff just provide reminder and assistance for R1's reposition. HWD stated FM requested that staff not to enter R1's room between 10:00PM to 6:00AM. HWD stated FM requested staff to check R1 every 4 hour and FM will use call button to call the facility if R1 needs assistance. HWD stated FM signed all R1's care plans. On 02/26/2026, LPA interviewed HWD. HWD stated in 01/08/2026 meeting, FM requested the facility not to enter R1's room between 10:00PM to 6:00AM. HWD stated on 1/14/2026, FM changed R1's hospice care agency. Continue on LIC9099-C. Page 2 of 4. On 3/13/2026, LPA interviewed FM. FM confirmed he/she has changed R1's hospice care agency. FM stated he/she requested to have a meeting with the facility on 01/08/2026 to review and update R1's care plan based on R1's health condition. FM stated the facility already improves a lot. FM stated he/she conducts R1's external catheter care and the hospice care agency conducts R1's shower service 2 times per week. FM stated he/she conducts R1's reposition every 4 hours and the facility staff provide reminder and assistance. Based on the review of R1's care plans dated on 11/26/2025 and 01/08/2026, R1 has bath service 2 times per week by R1's hospice care agency, FM provides R1's catheter care, and reposition R1 every 4 hours. The facility staff provide reminder and assistance for R1's reposition. Staff are not responding to resident's call button: On 01/16/2026, LPA interviewed Human Resource Director (HRD). HRD stated the facility staff respond to call button within 20 minutes. HRD stated the facility investigates/reviews the cases that staff respond to call button longer than 20 minutes. LPA interviewed Assisted Living Director (ALD). ALD stated the facility staff respond to resident's call button within 20 minutes. LPA interviewed Health and Wellness Director (HWD). HWD stated the facility staff respond to call button within 15-20 minutes. LPA interviewed resident R1's family (FM). FM stated he/she presses the call button very often because he/she requests the facility staff to enter R1's room at minimal as possible like every 4 hours and not to enter R1's room between 10:00PM to 6:00AM. FM stated the facility staff never un-responding to R1's call button. FM stated he/she does not have the date and time that the staff respond to call button not in a timely manner. Continue on LIC9099-C. Page 3 of 4. On 2/26/2026, LPA interviewed HWD. HWD stated the facility respond to call button within 20 minutes but if the residents request more service like nurse service, then it may take longer to finish. HWD stated the call button will be reset after the service completes even though caregivers respond immediately. HWD explained that is why some items in the call button log takes longer to clear. LPA interviewed 8 residents, 3 Out of 8 residents stated staff came with 10 minutes when they pressed call buttons and 5 Out of 8 residents stated they never used call buttons. On 3/13/2026, LPA interviewed FM. FM stated he/she does not gave the date and time that staff are not responding to resident's call button. Staff left a resident in a soiled diaper: On 01/16/2026, LPA interviewed Assisted Living Director (ALD) and Health and Wellness Director (HWD). Both stated R1's family (FM) conducts R1's catheter care. On 3/13/2026, LPA interviewed FM. FM stated he/she conducts R1's catheter care management, and the facility staff do not need to check/change R1's diaper every two hours. Based on the review of R1's care plan dated on 11/26/2025 and 01/08/2026, FM conducted R1's catheter care. The Department has investigated the above allegations. Based on the investigation, records reviewed, and interviews conducted, the Department found that the above allegation is UNFOUNDED, meaning that the allegation is false, could not have happened and/or is without a reasonable basis. No citations noted at today’s compliant investigation visit. Exit interview was conducted with ED. This report was provided to review and for signature. A copy of this report was provided to ED.the state’s words, verbatim · CDSS document, Mar 18, 2026 · control 26-AS-20260109162214

Allegation investigated: Staff did not prevent a resident from wandering Staff mishandled the residents personal belongings

Licensing Program Analyst (LPA) Monter conducted an unannounced complaint inspection to deliver the findings on the above allegation. LPA met with Administrator Jolie Higgins On July 7, 2025 the Department received a complaint alleging Staff did not prevent a resident from wandering. On July 14, 2025, Licensing Program Analyst (LPA) Steve Chang interviewed Memory Care Director Daleht Miranda, referred to as S1. S1 stated around March 2025, families had keys to enter and exit the memory care unit and that caused problem. S1 stated because family does not know all the residents, it creates a possibility of a resident following a family exit memory care unit. S1 stated in March or February 2025, resident R1 exited the memory care unit but was stopped by the front desk staff. Page 1 Out of 6 Unfounded On October 3, 2025, LPA Steve Chang interviewed Administrator (ADM) Kellie Shearer. ADM stated resident R1 followed other families who were exiting the memory care unit and took elevator to the lobby area. R1 was found by staff in the lobby area on March 12, 2025 around 9:05PM. ADM stated after the incident, the facility put doorbell at the memory care unit entrance door/exit door and the facility members need to buzz in and buzz out of the memory care unit. ADM stated staff need to open and close the exit door of the memory care unit. ADM stated the facility checked R1 after the incident and did not found any injury. On January 23, 2026, LPA Manuel Monter interviewed Staff S2-S6. 3 Out of 5 staff (S2, S3 S5) stated residents have attempted to elope from the memory care unit, but their attempts were thwarted by staff who intervened. S4 stated he/she is not aware of residents eloping from the memory care unit. S6 stated R1 did wander out of the memory care unit. S6 stated R1 managed to wander to the front door area, but the front desk was able to redirect R1 back to the memory care unit. S6 stated R1 was able to get down, by following a family down the elevator. S6 stated this only happened once. S6 stated family’s used to have the card/fobs to leave the facility. S6 stated after R1 was able to get down, they changed the procedures. S6 stated family now has to ring the door bell to enter and needs to ask for staff assistance to exit. On January 23, 2026, LPA Manuel Monter interviewed Assisted Living Director (ALD) Mayte Calderon. ALD stated she isn’t aware of any residents eloping from the facility. ALD stated residents have attempted to elope, but staff are able to redirect the residents who try to elope. On February 5, 2026, LPA Manuel Monter interviewed Community Life Director (CLD) Barbra Fleig. CLD stated she is not aware of R1 eloping from the memory care unit. CLD state other residents have attempted to leave the memory care unit, but staff intervenes and returns the residents back to the memory care unit. On February 5 & 9, 2026, LPA Manuel Monter interviewed Memory Care Director Daleht Miranda, referred to as S1 & Staff S7-S11. S1 stated she is aware when R1 had been found in the lobby by the front desk staff and redirect. 4 Out of 6 staff (S7-S10) stated they are not aware of any instance where a resident left the memory care unassisted and went to the first floor unassisted. S11 stated he/she is aware of an instance where a resident managed wander to the first floor but isn’t aware of the details. Page 2 Out of 6 On February 11, 2026, LPA Manuel Monter interviewed Executive Director (ED) Brenda Ritter. ED stated she isn’t aware of any instance of a memory care resident wandered down to the first floor without supervision. On February 12 and 25, 2026, LPA Manuel Monter interviewed staff S12-S14. 3 Out of 3 staff (S12-S14) acknowledged that R1 was able to leave the memory care unit unassisted. The Department reviewed R1's progress notes. Progress note dated March 12, 2025 states, R1 is doing well after elopement. R1 did not him/herself, no injuries noted. R1 stated he/she was accompanied by a woman and that all he/she did was push buttons and stepped foot into the elevator. R1 went to receptionist and concierge alerted nurses. Based on the totality of this investigation, R1 did leave the memory care unit unassisted and was on the first floor of the facility. Shortly after, R1 was found by the front desk staff, who re-directed R1 back to the memory care unit. Since the first floor is part of the facility grounds, R1 did not elope from the facility. Furthermore, R1 did not sustain any injuries and the facility implemented a change in policy, to prevent other potential wandering incidents. The Department has completed the investigation of the above allegations. Based on interviews conducted and records review, the department has found that the above allegations were UNFOUNDED, meaning that the allegations were false, could not have happened and/or are without a reasonable basis. Staff mishandled the residents personal belongings. On July 7, 2025 the Department received a complaint alleging Staff mishandled the residents personal belongings. On July 14, 2025, LPA Steve Chang interviewed Administrator (ADM) Kellie Shearer. ADM stated the facility policy is: if the facility receives a report of lost item from resident/family, the facility will ask if they want to report to Police Department. If yes, then the facility will report to the police. ADM stated the facility will help residents to search for the lost items. ADM stated if the value is more than $100, the facility will report incident to licensing. Page 3 Out of 6 On July 14, 2025, Licensing Program Analyst Steve Chang interviewed Administrator (ADM) Kellie Shearer. ADM stated every resident has Admission Agreement prior to moving in the facility. ADM stated only resident's POA can access resident's medical document. ADM stated resident POA need to submit a request in writing to access resident's medical records, and she needs to submit to corporate to approve. On January 23, 2026, Licensing Program Analyst Manuel Monter interviewed Staff S6. S6 stated he/she is aware of R1’s family member requesting documents from the facility. S6 stated he/she isn’t aware of what documents were requested. S6 stated when documents are requested, there is a process that needs to be followed, which takes a few days to process. S6 stated R1’s family member did get the documents he/she requested. On February 5, 2026, Licensing Program Analyst Manuel Monter interviewed Memory Care Director Daleht Miranda, referred to as S1. S1 stated if a family member requests an assessment or service plan, they can print. S1 stated R1’s family member did ask for documents and he/she did receive them at the time. On February 11, 2026, Licensing Program Analyst Manuel Monter interviewed Executive Director (ED) Brenda Ritter. ED stated regarding document requests from residents responsible parties: the facility will provide said documents if requested. ED stated for certain documents, the facility can provide a copy the same day. ED stated for more medical documents, there is a process that needs to be followed. ED stated they would need to fill out a medical request form. ED stated this would typically take a couple days. On February 17 & 25, 2026, Licensing Program Analyst Manuel Monter interviewed staff S12. S12 stated R1’s family member didn’t want to speak to him/her. S12 stated R1's family member only spoke with the administrator. S12 stated R1's family member did request documents. S12 stated he/she is aware that the ADM provided the requested documents. S13 stated he/she does remember R1’s FM requesting a copy of the MAR and some documents regarding medications. S13 stated he/she doesn’t remember what had happened with those requests. Staff S14 stated he/she does remember the back and forth from R1’s FM requesting documents. S14 stated he/she does remember providing said documents to R1’s FM. S14 stated he/she provided to him/her via physical paper in person. Page 2 Out of 10 On February 25, 2026, LPA Manuel Monter interviewed Former Administrator, (ADM) Kellie Shearer. ADM stated she does remember when R1’s FM had requested documents like the MAR and admission agreement. ADM stated S14 provided said documents. ADM stated she doesn’t know if the documents were provided in paper or email. ADM stated she doesn’t remember the details but reiterated but the documents were given. Based on investigation, records reviewed, and interviews conducted, the Department found that the above allegations are UNSUBSTANTIATED. An unsubstantiated finding indicates that although the allegation may have happened or is valid, there is not a preponderance of evidence to prove that the allegations did or did not occur. Staff did not follow a resident's dietary needs On July 7, 2025 the Department received a complaint alleging Staff did not follow a resident's dietary needs On July 12, 2025, Licensing Program Analyst Steve Chang interviewed Witness W1. W1 stated, he/she requested the facility not to give R1 milk, but the facility did not follow. W1 stated R1 does not have a doctors order for this dietary restriction. On July 14 and October 3, 2025, Licensing Program Analyst Steve Chang Administrator (ADM) Kellie Shearer. ADM stated if there is a physician order, then the facility will follow. ADM stated R1 does not have a special diet and does not have a doctors order for a restricted diet. ADM stated R1 does not have a doctors order not to give milk to R1. On January 20, 2026, Licensing Program Analyst Manuel Monter interviewed Witness W1. W1 stated he/she doesn’t think R1 had nondairy dietary restriction noted on R1’s physicians report. W1 stated he/she doesn’t know if it was noted on R1’s care plan. W1 stated he/she did state this food preference verbally to the administrator. Page 3 Out of 10 On January 23, 2026, LPA Manuel Monter interviewed Staff S2-S6. 4 Out of 5 staff (S2, S3, S4, S6) stated they are not aware of any instance where a resident was provided food that conflicted with a documented dietary restriction or preference. S5 stated he/she has seen staff serve a resident with a gluten dietary restriction, gluten. S5 stated when this occurred, he/she told that staff member not to serve that food. S5 stated he/she doesn’t recall when this occurred. On January 23, 2026, LPA Manuel Monter interviewed Assisted Living Director (ALD) Mayte Calderon. ALD stated the kitchen staff are aware of residents personal choices when it comes to food and their restricted diets and food they are allergic to. ALD stated she has not seen residents being served food that they were restricted from having. On January 23, 2026, LPA Manuel Monter interviewed residents R14-R18. 4 Out of 5 staff (R14-R17) stated they don’t have a special diet. Resident R18 was unable to provide any relevant information due to neurocognitive disorder. On February 5, 2026, LPA Manuel Monter interviewed Community Life Director (CLD) Barbra Fleig. CLD stated the dinning staff is aware of what food each resident can eat. CLD stated he/she isn’t aware of any instance where a resident was served food there were not able to eat. On February 5, 2026, LPA Manuel Monter interviewed Health and Wellness Director (HW) Baneen Amiri. HW stated residents diet restrictions are based on doctors orders. HW stated they can also enter the residents preferences into their system, so the people who make the meals are aware. HW stated she isn’t aware of any issues regarding residents being served meals they are not supposed to get. On February 5 & 9, 2026, LPA Manuel Monter interviewed Memory Care Director Daleht Miranda, referred to as S1 & Staff S7-S11. 5 Out of 6 staff (S1, S7-S10) stated they are not aware of any instance where a resident was provided food that conflicted with a documented dietary restriction or preference. S11 stated residents don’t eat meals during his/her shift. On February 11, 2026, Licensing Program Analyst Manuel Monter interviewed residents R5, R6, R19-R22. 6 Out of 6 residents (R5, R6, R19-R22) stated they don’t have any dietary restrictions. Page 4 Out of 10 On February 11, 2026, Licensing Program Analyst Manuel Monter interviewed Executive Director (ED) Brenda Ritter. ED stated the facility and kitchen staff have diet cards for all residents: regarding their dietary restrictions or food preferences. ED stated the staff in the memory care unit, who serve the residents food also know who has dietary restrictions. ED stated she isn’t aware of any instance where a resident was served food that was on their dietary restriction list. On February 17 & 25, 2026, Licensing Program Analyst Manuel Monter interviewed staff S12-S14. S12 stated he/she is aware of an instance where a resident with a restricted diet was given food they were not supposed to have. S12 stated resident has a gluten restriction. S12 stated when this resident first moved in, it was difficult for staff to remember not to give that resident gluten. S12 stated he/she knows this occurred but cannot remember the details of when this occurred. Staff S13 and S14 stated they are not aware of any instance were a resident was given a meal that conflicted with their dietary restrictions/preferences. On February 25, 2026, LPA Manuel Monter interviewed Former Administrator, (ADM) Kellie Shearer. ADM stated if a resident has a dietary restrictions, then the doctor will put in an order. ADM stated she doesn’t remember if R1 had a dietary restriction. ADM stated if R1 did have one, it would be listed in the residents file. ADM stated there hasn’t been a time when a resident was given a meal that conflicted with their dietary restrictions/preferences. The Department reviewed R1’s Care Evaluation, dated July 6, 2025. Under Dietary, the evaluation states staff will assist with low/non-fat milk or alternative diary intake. The Department reviewed R1's Service plan dated, July 14, 2025. Under dietary, the service plan states R1 can be provided low/non-fat milk or alternative dairy. Based on investigation, records reviewed, and interviews conducted, the Department found that the above allegations are UNSUBSTANTIATED. An unsubstantiated finding indicates that although the allegation may have happened or is valid, there is not a preponderance of evidence to prove that the allegations did or did not occur. Page 5 Out of 10 Staff do not have planned activities On July 7, 2025 the Department received a complaint alleging Staff do not have planned activities. On July 14, 2025, Licensing Program Analyst Steve Chang interviewed Administrator (ADM) Kellie Shearer. ADM stated the facility has Assistant Living unit and Memory Care unit activities schedules. ADM stated the Memory care unit has the screen to displaying the activities schedule. ADM stated residents of Memory care unit participate in the activities more than 90%. LPA Steve Chang interviewed Community Life Director (CLD) Barbara Fleig. CLD stated the facility has different activities for Assist Living Unit and Memory Care Unit every day. CLD stated the facility has special event each week for everyone. CLD stated the activity schedules are shown on several screens at each floor including Assistant Living unit and Memory Care Unit. CLD stated for memory care unit around 90% residents participate in the activity. On January 23, 2026, Licensing Program Analyst Manuel Monter interviewed Staff S2-S6. 5 Out of 5 staff (S2-S6) stated they are not aware of any instance when residents were not provided activities. On January 23, 2026, LPA Monter interviewed Assisted Living Director (ALD) Mayte Calderon. ALD stated the memory care unit does have activities. ALD stated they have live music, daily chronical, outings, scenic drives, (simple) book club. ALD stated she isn’t aware of anytime when residents were not provided activities. On January 23, 2026, LPA Manuel Monter interviewed residents R14-R18. 4 Out of 5 staff (R14-R17) stated the facility is providing activities to residents. Resident R18 was unable to provide any relevant information due to neurocognitive disorder. On February 5, 2026, Licensing Program Analyst Manuel Monter interviewed Community Life Director (CLD) Barbra Fleig. CLD stated the facility does have activities. CLD activities might include karaoke, daily chronical, puzzles, exercise at 10am, a brain game at 10:30. CLD stated on Wednesdays the facility has an entertainer come in. CLD stated they also have yard games, when the weather allows it. CLD stated they have different activities everyday and its listed on their activity schedule. CLD stated there hasn’t been a time when there wasn’t any activities in the memory care unit. Page 6 Out of 10 On February 5 & 9, 2026, Licensing Program Analyst Manuel Monter interviewed Memory Care Director Daleht Miranda, referred to as S1 & Staff S7-S11. 4 Out of 6 staff (S1, S7, S9, S10) stated they are not aware of any instance when residents were not provided activities. S8 stated he/she believes there was some issues with staffing, which caused issues with the activities. S8 stated this occurred in the beginning, over a year ago. S8 stated he/she can’t provide specific examples since it was over a year ago. S11 stated they don’t conduct activities during his/her shift. On February 11, 2026, Licensing Program Analyst Manuel Monter interviewed residents R5, R6, R19-R22. 6 Out of 6 residents (R5, R6, R19-R22) stated the facility provides activities and there hasn’t been a time when the facility didn’t have activities. On February 11, 2026, Licensing Program Analyst Manuel Monter interviewed Executive Director (ED) Brenda Ritter. ED stated the facility has a large variety of activities. ED stated they have their Calendar showing what activities are available for that month. ED Stated they also try to emphasize having different activities. ED stated she isn’t aware of any instance where the facility did not provide any activities On February 17 and 25, 2026, Licensing Program Analyst Manuel Monter interviewed staff S12-S14. 2 Out of 3 staff (S12, S13) stated there hasn’t been an instance where no activities were conducted. S14 stated he/she is aware of there being possible issues with the activities in terms of staffing when the facility first opened, S14 stated this was only what he/she heard and can’t remember the details. The Department reviewed R1's Activity Participation Log, dated February 19, 2025 - July 30, 2025. Based on a review, R1 participated in a variety of activities such as but not limited to: giant yahtzee, movie atinee, upper body blast, brain games, slow flow yoga, bingo, joyful movement cardio, karaoke, jeopardy, seated stretching, indoor bowling, Sunday sounds with Jenna, virtual church service with Joel Olsteen, and balloon volleyball. Based on investigation, records reviewed, and interviews conducted, the Department found that the above allegations are UNSUBSTANTIATED. An unsubstantiated finding indicates that although the allegation may have happened or is valid, there is not a preponderance of evidence to prove that the allegations did or did not occur. Page 7 Out of 10 Staff mishandled the residents medications On July 7, 2025 the Department received a complaint alleging Staff mishandled the residents medications. On July 12, 2025, Licensing Program Analyst Steve Chang interviewed Witness W1. W1 stated R1’s doctor prescribed medication M1, but the facility did not administer to R1. W1 stated the facility administered M1 to R1 the next day after he/she found the facility did not administer M1 to R1. On January 23, 2026, Licensing Program Analyst Manuel Monter interviewed Staff S2-S6. 5 Out of 5 Staff (S2-S6) stated they are not aware of any issues regarding residents medications. On January 23, 2026, Licensing Program Analyst Manuel Monter interviewed Assisted Living Director (ALD) Mayte Calderon. ALD stated he/she isn’t aware of any issues regarding residents medications. On January 23, 2026, Licensing Program Analyst Manuel Monter interviewed residents R14-R18. 4 Out of 5 staff (R14-R17) stated they have not had any issues regarding their medication. Resident R18 was unable to provide any relevant information due to neurocognitive disorder. On February 5, 2026, Licensing Program Analyst Manuel Monter interviewed Community Life Director (CLD) Barbra Fleig. CLD stated she is not aware of any issues regarding residents medications. On February 5, 2026, LPA Manuel Monter interviewed Health and Wellness Director (HW) Baneen Amiri. HW stated during her time working at the facility, she hasn’t observed or been informed about any issues regarding medications. LPA showed HW R1’s MAR during interview. HW stated she can’t explain why there are blank spots on R1’s MAR. Page 8 Out of 10. On February 5 & 9, 2026, Licensing Program Analyst Manuel Monter interviewed Memory Care Director Daleht Miranda, referred to as S1 & Staff S7-S11. S1 stated there have been times when there was medication errors. S1 stated it has been a long time ago. S1 stated regarding R1’s medication, she remembers there was an issue, regarding R1’s MAR for medication M1. S1 stated there were a couple of spots that were not signed. 3 Out of 6 Staff (S7, S8, S11) stated he/she is not aware of any issues regarding residents medications. 2 Out of 6 staff (S9, S10) stated on at least 2 occasions they have observed unsecured medications tablets in the dinning room or residents bedrooms. On February 11, 2026, Licensing Program Analyst Manuel Monter interviewed residents R5, R6, R19-R22. 6 Out of 6 residents (R5, R6, R19-R22) stated they get assistance with their medication administration and have not had any issues with their medications. On February 11, 2026, Licensing Program Analyst Manuel Monter interviewed Executive Director (ED) Brenda Ritter. ED stated she does not administer residents medications. ED stated she is not aware of any instance where a resident was not provided their medication. On February 17 & 25, 2026, Licensing Program Analyst Manuel Monter interviewed staff S12-S14. S12 stated he/she is aware of a medication issue that occurred with resident R1. S12 stated this error occurred sometime around march 2025. S12 stated R1 had a mediation, M1. S12 stated R1 had an update dosage, from 5mg to 10 mgs, based on what S12 remembers. S12 stated the facility was under administering. S12 stated he/she can’t remember the details. S13 stated he/she isn’t aware of any issues regarding residents medications. S13 stated R1’s Family member(FM) believed there was in issue with R1’s medication M1. S13 stated R1 had a medication based on a trail period. S13 stated after the trail period had ended, there wasn’t a new prescription to continue using M1. S13 stated he/she had to explain to FM that they can’t administer a medication until they have a doctors order. S13 stated he/she can’t remember the details since it was a year ago. Page 9 Out of 10. S14 stated there was a few medication errors but cannot remember when this happened or the name of the resident. S14 stated he/she does remember there was some sort of discussion regarding R1’s medication. S14 stated there was an issue getting a doctors order for R1’s medication M1. S14 stated it wasn’t a medication error, the issue was the doctor had not sent the order for M1, and the facility wasn’t able to administer. S14 stated he/she doesn’t’ remember when this issue came up. On March 4, 2026, Licensing Program Analyst Manuel Monter randomly audited 4 resident centrally stored medication records. The medication audit was completed by cross-referencing the residents’ medications containers with the Centrally Stored Medication log. As a result, LPA did not find any discrepancies. The Department reviewed R1's Medication Administration record dated July 2025. Under medication M1, there are several blank spaces. Based on investigation, records reviewed, and interviews conducted, the Department found that the above allegations are UNSUBSTANTIATED. An unsubstantiated finding indicates that although the allegation may have happened or is valid, there is not a preponderance of evidence to prove that the allegations did or did not occur. Page 10 Out of 10. END OF REPORT. On July 29, 2025, the Department interviewed Witness W1. W1 stated on July 16, 2025 when visiting R1, he/she requested to give R1 a shower and asked for R1’s personal care items. W1 stated he/she was given a shower caddy from their med room and discovered that he/she had personal care items in R1’s caddy that were not his/hers. W1 stated the shampoo and soap that belonged to R1 were almost empty. W1 stated he/she could not find the lotion for R1 legs. W1 stated staff could not locate the items he/she supplied and paid for. W1 stated R1 is still missing several items including blankets, tv remote, and a box of ace bandages. W1 stated he/she does not know if the missing items were logged in the personal property log. On January 23, 2026, Licensing Program Analyst Manuel Monter interviewed Staff S2-S6. 4 Out of 5 staff (S2-S4, S6) stated they are not aware of any instance of residents losing property. S2 acknowledged there may have been times when residents shampoos may have been mixed with other residents cubbies. S5 stated he/she heard there was an issue regarding R1’s shampoos, but doesn’t know the details. On January 23, 2026, Licensing Program Analyst Manuel Monter interviewed Assisted Living Director (ALD) Mayte Calderon. ALD stated she doesn’t know about residents losing things. ALD stated she hasn’t heard or aware of any issues. ALD stated she isn’t aware of bathing products being misplaced. On January 23, 2026, Licensing Program Analyst Manuel Monter interviewed residents R14-R18. 4 Out of 5 staff (R14-R17) stated they have not had any issues with losing personal property. Resident R18 was unable to provide any relevant information due to neurocognitive disorder. On February 5, 2026, Licensing Program Analyst Manuel Monter interviewed Community Life Director (CLD) Barbra Fleig. CLD stated if something is lost in the memory care unit, the care staff will look for said missing object. CLD stated the memory care unit is only 1 floor and things are easy to find. CLD stated he/she is not aware of any issues of residents losing personal property. On February 5 & 9, 2026, LPA Manuel Monter interviewed Memory Care Director Daleht Miranda, referred to as S1 & Staff S7-S11. S1 stated if something is lost with the value of over 100 dollars, then the facility will report it to the police. S1 stated they will also ensure that when residents move in, their personal property they want to be kept safe, is logged on the personal property log. S1 stated she doesn’t know what has occurred regarding R1’s missing things or if they were ever found. Page 4 Out of 6. S7 & S11 stated they are not aware of any issues of residents losing personal property. S8 stated he/she is aware when R1 had allegedly lost his/her foot stool. S8 stated the issue was R1 will pick up and move the foot stool around the memory care unit. S8 stated he/she isn’t aware of the outcome of the issue. S9 stated he/she does faintly remember R1 losing a foot stool. S9 stated he/she remembers looking for it. S9 stated he/she doesn’t remember what happened regarding the foot stool. S10 stated he/she isn’t aware of R1 losing personal property. S10 stated there was instances where residents shampoos and bathing products were swapped or missing. On February 11, 2026, LPA Manuel Monter interviewed residents R5, R6, R19-R22. 6 Out of 6 residents (R5, R6, R19-R22) stated they haven’t had any issues with their personal property going missing. On February 11, 2026, LPA Manuel Monter interviewed Executive Director (ED) Brenda Ritter. ED stated she isn’t aware of any instance where a residents personal property had gone missing. ED stated recently there was a resident who “lost” there broom and dust pan and red sheets that were allegedly missing. ED stated she did find the broom and dust pan next to the residents fridge. ED Stated they compensated residents losing property as a credit. ED stated they compensate to give the resident the benefit of the doubt and since these are small charges, it’s a way to keep the residents satisfied with the care is being provided. On February 17 & 25, 2026, Licensing Program Analyst Manuel Monter interviewed staff S12 – S14. S12 stated he/she is aware that it had been alleged that R1 had missing property. (pair of shoes, foot stool). S12 acknowledged that they did replace those items financially. S12 stated they did a whole memory care unit search but didn’t find said items. S12 stated R1’s Family member wanted the foot stool in the public space, where R1 would usually sit. S12 stated it might have been possible R1’s showering products were placed in the wrong cubby, but he/she isn’t aware of this happening. S13 stated he/she isn’t aware of any issues regarding residents losing personal property. S13 stated nothing was ever mentioned to him/her about missing property. S14 stated he/she faintly remembers hearing about a missing foot stool and blanket. S14 stated it was ongoing where it would go missing and then be found elsewhere. S14 stated he/she isn’t aware if the blanket or foot stool went missing again or was found again. S14 stated he/she is not aware of any issues regarding residents shampoos / bathing products mixing with other residents shampoos/ bathing products. Page 5 Out of 6. On February 25, 2026, LPA Manuel Monter interviewed Former Administrator Kellie Shearer. ADM stated there were items that may have been misplaced, blankets, sheets, they would replace them. ADM stated if was a person misplaced an item, the facility trying to make amends. ADM stated they will believe the residents if they state they can’t find something. ADM stated staff will try to search for it and compensate to make amends. ADM stated the residents in the memory care unit would take things and move them around the memory care unit. ADM stated R1’s missing items were not in the personal property log and R1’s daughter did not request to add them. ADM stated R1’s FM was compensated for the missing items. The Department reviewed R1's Personal Property and Valuables Log, LIC621, dated February 16, 2025. Based on a review, this form is blank and signed on the bottom. The Department reviewed R1's Watermark at San Jose Ledger Report, February 18 - September 2, 2025. The ledger states effective August 28, 2025, R1's was granted $450 in credit for missing items. The ledger states effective September 1, 2025, R1 was granted $418.22 in credit for missing items and erroneous care charges. The Department reviewed Resident R1's Revenue Concessions Reports, dated August 27, 2025 & September 1, 2025, & September 2, 2025. The report states R1 was compensated for the following missing items: foot stool, TV and Remote, Ace bandages, and Hamper. The Department has completed the investigation of the above allegations. Based on interviews conducted and records review, the department has found that the above allegations were UNFOUNDED, meaning that the allegations were false, could not have happened and/or are without a reasonable basis. Page 6 Out of 6. END OF REPORTthe state’s words, verbatim · CDSS document, Mar 5, 2026 · control 26-AS-20250707122429

Type of visit: Case Management - Deficiencies

Licensing Program Analyst Manuel Monter conducted an unannounced case management- deficiencies , regarding violations discovered during the complaint investigation for 26-AS-20250929092054. LPA met with Administrator Jolie Higgins Reporting Requirements During complaint investigation, The Department reviewed R1's progress notes. Progress note dated March 12, 2025 states, R1 is doing well after elopement. R1 did not him/herself, no injuries noted. R1 stated he/she was accompanied by a woman and that all he/she did was push buttons and stepped foot into the elevator. R1 went to receptionist and concierge alerted nurses. The Department reviewed resident R23 and R24's Progress notes. Progress note dated March 2, 2025 states staff S11, Heard commotion in the hallway. R23 was noted in the hallway in front of apartment door. Two residents were in the hallway being separated by 3 care givers. 1 care giver informed S11 that R24 had a knife and was trying to stab R23. S11 redirected R24 to his/her apartment. On February 25, 2026. LPA Manuel Monter requested documentation for the incident reports that were sent for the two incidents noted on the progress notes. LPA was informed on February 25, 2026, that the facility does not have documentation for both of these incidents. Page 1 Out of 2. Medication Errors During complaint investigation, LPA interviewed facility staff regarding medication errors regarding R1’s medication. Interviews with staff revealed potential medication errors, that were not associated with the complaint investigation. At this time, these instances of medication errors are under review and Department will conduct a follow up visit , if warranted. A technical violation and Deficiency is being cited per California Code of Regulations, Title 22. See LIC809-D. This report was reviewed with Administrator Jolie Higgins and a copy of the report and appeal rights were provided Page 2 Out of 2. END OF REPORTthe state’s words, verbatim · CDSS document, Mar 5, 2026

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87211(a)(1) · Plan of correction due date: Mar 12, 2026

87211 Reporting Requirements (a)(1) A written report shall be submitted to the licensing agency … within seven days of the occurrence of any of the events specified in (A) through (D) below… date and nature of event… and disposition of the case. This requirement was not met as evidence by: Based on records reviewed and interviews conducted, the facility did not submit a report to licensing regarding the event on 03/12/25 and 3/2/2025. Health and Wellness director confirmed they do not have the reports dated 3/2/25 & 3/12/2025 to provide the Department.the state’s words, verbatim · CDSS document, Mar 5, 2026

Plan of correction: ADM stated she will send a letter of understanding regarding the regulation. (Continue) This poses a potential health, safety or personal rights risk to persons in care.

Allegation investigated: Facility staff handles residents in a rough manner Facility staff do not treat residents with dignity and respect Facility staff are not meeting the resident's incontinence care needs Facility staff did not ensure to provide residents with adequate bedding in a timely manner Facility staff do not provide adequate laundry service

Licensing Program Analyst (LPA) Simi Rai conducted an unannounced visit to conclude the complaint investigation. LPA Rai met with the Health and Wellness Director, Baneen Amiri and stated the purpose of today’s visit. On 9/12/2025, the Department received a complaint with the above allegations. On 9/19/2025, the Department conducted an initial investigation at the facility. Continuation on LIC 9099-C, Page 1 of 6. Unsubstantiated Page 2 of 6. Facility staff handles residents in a rough manner. It was alleged that staff (S1) is often rough with residents when assisting them. On 9/19/2025, the Department interviewed 7 residents (R1-R7). 6 Out of 7 residents stated the staff, including S1, are not rough with them when they assist them. R3 stated staff S1 would push the wheelchair really fast and then suddenly stop causing a jerking movement. R3 stated he/she does not have feelings on the right side of the body, including leg and it’s hard for R3 to determine if S1 is being rough. On 12/18/2025, LPA Rai interviewed 2 staff. 2 Out of 2 staff stated they have not seen or heard of staff S1 being rough with resident when assisting them. S2 stated he/she has seen S1 assist another resident in the bathroom and the resident stated “a man is hurting me” but S1 was lifting the resident which made the resident uncomfortable and it was not rough. LPA Rai interviewed Interim Executive Director, Brenda Ritter, who stated they conducted an internal investigation, and they did not find a preponderance of evidence to prove the allegation. On 02/05/2026, LPA Rai interviewed 7 staff (S4-S10). 7 Out of 7 staff stated they have not seen S1, or any other staff bring rough with residents at the facility. S7 stated he/she worked with S1 during the same shift and did not observe S1 being rough with residents. During this investigation, LPA Rai attempted to reach out to S1 but was unsuccessful. S1 no longer works at the facility. Facility staff do not treat residents with dignity and respect. It was alleged that staff (S1) make fun of resident R3. On 9/19/2025, the Department interviewed 7 residents. 6 Out of 7 residents stated the staff, including S1, treat them with dignity and respect. R3 stated staff S1 did mock him and repeated a word in a sarcastic tone but did not give any other examples or incidents. Page 3 of 6. On 12/18/2025, LPA Rai interviewed 2 staff. 2 Out of 2 stated they have not seen or heard staff S1 making fun of residents. S2 stated R3 has stated that S1 said R3 “was stupid”, but S2 has not seen this interaction. S2 stated R3 has not brought up any other similar incidents in the past. LPA Rai interviewed Interim Executive Director, Brenda Ritter, who stated they conducted an internal investigation, and they did not find a preponderance of evidence to prove the allegation. On 02/05/2026, LPA Rai interviewed 7 staff (S4-S10). 7 Out of 7 staff stated they did not see or hear staff S1 or other staff making fun of resident R3. 4 Out of 7 staff stated that resident R3 would not treat staff with dignity and respect. 4 out of 7 staff stated R3 would be disrespectful towards staff which would include R3 yelling at them. During this investigation, LPA Rai attempted to reach out to S1 but was unsuccessful. S1 no longer works at the facility. Facility staff are not meeting the residents’ incontinent care needs It was alleged that PM staff did not assist resident R1 with PureWick system which caused R1 to be soiled a lot more than usual. On 9/19/2025, the Department interviewed 7 residents (R1-R7) 1 out of 7 residents was confused about their incontinent status. 1 out of 7 residents stated they do not have any incontinent care needs and staff are available to assist as they check on the residents throughout the day. On 9/19/2025, LPA Christine Kabariti observed 7 resident rooms, including R1’s room. 7 Out of 7 resident’s rooms did not have a foul order which would indicate the residents were not changed in a timely manner causing saturation of urine and stool in the resident’s bedding. Page 4 of 6. On 12/18/2025, LPA Rai interviewed 2 staff. 2 Out of 2 staff stated the staff are checking on the resident every 2 hours and using the electronic device to initial on R1’s chart about observing Purewick and if R1 needs assistance with Purewick. Both staff stated they have not seen or heard about R1’s incontinent care needs not being met by the staff. LPA Rai interviewed Interim Executive Director, Brenda Ritter, who stated they conducted an internal investigation, and they did not find a preponderance of evidence to prove the allegation. On 02/05/2026, LPA Rai interviewed 7 staff (S4-S10). 6 Out of 7 staff stated the staff did provide incontinence care to resident R1 and they were meeting R1’s incontinence care needs in regard to the Purewick. S6 stated they worked directly with R1 and has assisted R1 with the Purewick. S7 stated there were 1 or 2 incidents in the past where the Purewick was not placed correctly which caused resident to be soiled but the staff were able to fix the problem right away. Based on review of R1’s Physician’s Report dated 11/13/2024, R1 is incontinent with bladder impairment and is unable to care for their own toileting needs. Based on review of R1’s Service Plan Report dated 7/30/2025, the facility staff are to assist the resident with Purewick at night. Facility staff did not ensure to provide residents with adequate bedding in a timely manner. It was alleged that residents are not provided with bedding (sheets and bed covers) for days. On 9/19/2025, the Department interviewed 7 residents. 2 out of 7 residents did not express concern about having adequate bedding in their room. On 9/19/2025, LPA Christine Kabariti observed 7 resident rooms. 7 Out of 7 resident’s beds had bedsheets and linens. Page 5 of 6. On 12/18/2025, LPA Rai interviewed 2 staff. 2 Out of 2 staff stated residents are responsible to providing their own bedding however, the facility does have extra bedding sheets to use and will provide them to the residents. Neither staff have seen residents without bedding in their rooms. LPA Rai interviewed Interim Executive Director, Brenda Ritter, who stated they conducted an internal investigation, and they did not find a preponderance of evidence to prove the allegation. On 02/05/2026, LPA Rai interviewed 7 staff (S4-S10). 7 Out of 7 staff stated the facility staff do provide residents with adequate bedding. 7 Out of 7 staff stated they have not seen or heard any issues with residents not having bedding in their room. Facility staff do not provide adequate laundry service. It was alleged the staff are not washing resident’s clothing where laundry hampers are overflowing, causing residents to wash their own clothing in their sinks as well as not having clothing to wear. On 9/19/2025, the Department interviewed 7 residents (R1-R7). 5 Out of 7 residents stated the facility staff do provide adequate laundry services. 2 Out of 7 residents could not provide information about the laundry service, but resident stated they have clothes available to wear. On 9/19/2025, LPA Christine Kabariti observed 7 resident rooms. LPA Kabariti observed 6 out of 7 residents’ baskets were full. LPA Kabariti observed that 7 out of 7 residents had more than 5 articles of clothing available such as blouses and pants located in the closet and dresser for resident’s use. On 12/18/2025, LPA Rai interviewed 2 staff. 2 Out of 2 staff stated there is a laundry schedule that the staff will follow and the care staff will do small loads as needed for the residents. Both staff stated they have not seen residents without clean clothes or laundry service was not completed for a resident. LPA Rai interviewed Interim Executive Director, Brenda Ritter, who stated they conducted an internal investigation, and they did not find a preponderance of evidence to prove the allegation. Page 6 of 6. On 02/05/2026, LPA Rai interviewed 7 staff (S4-S10). 7 Out of 7 stated the facility staff do provide adequate laundry services. 3 Out of 7 staff stated there is a resident that has a behavior where he/she will wash their own intimates in the shower however the facility staff will wash the items in the washing machine as well. S7 stated the resident has the behavior and it is not related to the facility staff not providing laundry services. S8 stated the residents may wear their favorite sweater or cardigan multiple times but they have not seen residents wear the same clothes two days in a row. Based on review of resident laundry shift effective 9/8/2025, each resident was assigned a specific date when the laundry would be completed, and each resident was provided laundry service every week. Based on the interviews conducted with clients and staff and based on observation and records review, although the allegations may have happened or are valid, there is not a preponderance of evidence to prove that the above allegations did or did not occur, therefore the allegations are UNSUBSTANTIATED. No deficiencies cited from California Code of Regulations, Title 22. Exit interview conducted with Health and Wellness Director, Baneen Amiri and a copy of the report was provided.the state’s words, verbatim · CDSS document, Feb 26, 2026 · control 26-AS-20250912131641

Allegation investigated: Staff do not properly maintain a resident's room Staff do not meet a resident's hygiene needs and laundry needs.

Licensing Program Analyst (LPA) Monter conducted an unannounced complaint inspection to deliver the findings on the above allegation. LPA met with Human Resurce Director (HRD) Carolina Villar-Mata On July 7, 2025 the Department received a complaint alleging Staff do not properly maintain a resident's room. On July 14, 2025, Licensing Program Analyst Steve Chang interviewed residents R1- R7. R1 stated facility staff never clean his/her room. 1 Out of 7 residents (R2) interviewed were unable to provide any relevant information due to neurocognitive disorder. 1 Out of 7 residents (R3) stated he/she does not remember how often staff clean his/her room. 4 Out of 7 Residents interviewed (R4-R7) stated the facility staff clean his/her room once a week. Unsubstantiated On July 14, 2025, LPA Chang interviewed residents R1-R5. R1 stated facility staff never clean his/her room. 2 Out of 7 residents (R2 & R3) stated they don’t know how often the staff clean their room. 4 Out of 7 residents (R4-R7) stated facility staff clean their room once a week. On July 14, 2025, LPA Steve Chang interviewed Administrator (ADM) Kellie Shearer. ADM stated housekeepers clean residents room once per week. ADM stated caregivers take out trash when caregivers visit resident rooms. ADM stated the facility has scheduled laundry and scheduled cleaning room for resident. On July 14, 2025, LPA Steve Chang toured the following bedrooms: 205, 221A, 254, 422, 448, 434, 516, 527, 552, 553. LPA observed the bedrooms in a sanitary condition, with no trash on the floor or tables. On October 3, 2025, LPA Chang interviewed residents R8-R13. 6 Out of 6 residents interviewed (R8-R13), stated facility staff clean their bedroom once a week. On January 20, 2026, LPA Monter interviewed witness W1. W1 stated R1’s bedroom is filthy. W1 stated he/she could tell staff are not dusting. W1 stated he/she cleans R1’s bedroom him/herself. On January 23, 2026, LPA Manuel Monter interviewed residents R14-R18. 4 Out of 5 residents (R14-R17) stated their room is cleaned every day. 4 Out of 5 residents (R14-R17) stated they have not had any issues with the cleanliness of his/her room. R18 was unable to provide any relevant information due to neurocognitive disorder. On January 23, 2026, LPA Manuel Monter toured the memory care unit inside and out. LPA toured the following bedrooms: 234, 236, 238, 240 A+B, 242, 244, 246, 247, 249, 248, 250, 253, 252, 254, 257, 256, 259 A+B, 258, 222, 221 A+B, 218, 220, 216 A+B, 214, 212, 210, 209, 208, 207, 205, 206, 203, 200 A+B, 201 A+B. During the tour of the memory care unit, LPA did not observe any areas as unclean, unhygienic or disorderly. On January 23, 2026, LPA Monter interviewed staff S2-S6. 5 Out of 5 Staff (S2-S6) stated housekeeping cleans residents bedrooms and care staff will spot clean the bedroom as well. 5 Out of 5 Staff (S2-S6) stated they are not aware or have never seen a residents bedroom as dirty or neglected. On January 23, 2026, LPA Monter interviewed Assisted Living Director (ALD), Mayte Calderon. ALD stated the housekeeping cleans the residents’ bedrooms. ALD stated the care staff will spot clean a resident bedroom. ALD stated if a resident has an accident, then care staff will clean it and housekeeping will do a deep clean. ALD stated she is not aware and or has never seen a resident bedroom as dirty or neglected. On February 5, 2026, LPA Manuel Monter interviewed Maintenance Director (MD) Mithun Prasad. MD stated general cleaning of the residents bedrooms are divided up between the care givers and housekeeping. MD stated the care givers do general everyday pick up and housekeeping will do the more in-depth cleaning. MD stated the cleaning of the residents bedrooms are done via schedule. MD stated he will go at least once a week and do random checks on the rooms. MD stated during his time working at the facility, he hasn’t observed any issues regarding cleanliness. LPA Monter interviewed Health & Wellness Director (HW) Baneen. HW stated she has not seen any resident bedroom that was not clean or neglected. HW stated residents bedrooms are cleaned. LPA Monter interviewed Memory Care Director MCD, Daleht Miranda. MCD stated he/she has not seen any residents bedrooms that were not clean or were neglected. On February 11, 2026, LPA Manuel Monter interviewed residents R19-R22. 4 Out of 4 residents interviewed (R19-R22) stated they bedrooms are cleaned weekly and have not had any issues with their bedrooms not being cleaned. On February 5, 11 & 17, 2026, Licensing Program Analyst Manuel Monter interviewed Staff S7-S12. 4 Out of 6 staff (S7, S10, S11) stated they have not seen any resident bedroom that were not clean or were neglected. S8 stated, some time in June-August 2025, there was instances when residents rooms were not cleaned timely, due to staffing issues. S8 stated the facility did have troubling but doesn’t recall any specific incidents but stated it occurred in June-August 2025. Staff S9 stated he/she has seen bedrooms that were not cleaned by other shifts. S9 stated this occurred months ago, but cannot recall details on where or when this occurred. Based on investigation, records reviewed, and interviews conducted, the Department found that the above allegations are UNSUBSTANTIATED. An unsubstantiated finding indicates that although the allegation may have happened or is valid, there is not a preponderance of evidence to prove that the allegations did or did not occur. Staff do not meet a resident's hygiene needs and laundry needs. On July 7, 2025 the Department received a complaint alleging Staff do not meet a resident's hygiene needs and laundry needs. It has been alleged R1’s laundry needs and showering needs were not being met. On July 14, 2025, Licensing Program Analyst Steve Chang interviewed residents R1-R7. R1 stated the facility staff never do the laundry for him/her. R1 stated the facility staff never showered him/her. R2 stated he/she does not remember how often the facility does his/her laundry and how often he/she has showers. R3 stated he/she receives a shower once a week. R4 stated he/she takes 4 showers a week. R6 stated he takes 2 showers a week. 3 Out of 7 residents ( R3, R4, R6) stated the facility staff do their laundry once a week. 2 Out of 7 residents (R5, R7) stated they do their own laundry and shower themselves. On October 3, 2025, Licensing Program Analyst Steve Chang interviewed residents R8-R13. 2 Out of 6 residents (R8, R9) stated the facility does their laundry once per week. 4 Out of 6 residents ( R10-R13) stated they do their own laundry. 6 Out of 6 residents (R8-R13) stated they have a shower every week. On October 3, 2025, LPA Steve Chang interviewed ADM Kellie Shearer. ADM stated usually the facility residents has 2 showers per week. ADM stated R1 has one shower per week because R1 does not like to have shower and sometimes refuses showers. ADM stated staff changed R1's clothes every day. ADM stated R1 has laundry completed once per week or as needed. On January 20, 2026, LPA Manuel Monter interviewed Witness W1. W1 stated he/she had booked a dentist appointment for R1 a few weeks in advanced. W1 stated he/she was called by an unknown staff member asking if they could drop off R1 an hour earlier. W1 stated he/she was told that day they needed to transport another resident. W1 stated he/she told them they couldn’t do that and leave R1 alone at the dentist. W1 stated he/she canceled the transport. RP stated he/she picked up R1 and took him/her to the dentist. On January 23, 2026, Licensing Program Analyst Manuel Monter interviewed residents R14-R18. 3 Out of 5 residents (R14,R16,R18) interviewed were unable provide any relevant information due to neurocognitive disorder. 2 Out of 5 residents (R15,R17) stated their family takes them to their appointments. On January 23, 2026, LPA Manuel Monter interviewed Staff S2-S6. 4 Out of 5 staff (S2-S5) stated they are not aware or have knowledge about the facility transportation. S6 stated there was a request to take R1 to a dentist appointment. R1’s family member (FM) wanted the driver to sit there parked until R1’s FM arrived. S6 stated there was a large time the driver would have to wait. S6, stated the facility asked if they could possible change the schedule. S6 stated FM canceled the appointment all together. S6 stated the transportation event didn’t even occur. On February 5, 2026, LPA Manuel Monter interviewed staff S7-S10. 3 Out of 4 staff (S7, S9, S10) stated they are not aware of or don’t have knowledge about the facility transportation. S8 stated the issue, regarding the facility transportation, is residents will make an appointment, but then will change their mind. S8 stated the residents will ask to change their schedule and get upset when the facility is not able to meet their last-minute request. LPA Manuel Monter interviewed Memory Care Director Daleht Miranda, referred to as S1. S1 stated, Family’s will request transportation, for medical appointments. S1 stated Transportation requests go thru the front desk and see if they can fit it in the schedule. S1 stated she is not aware of any issues regarding the facility’s ability to provide transportation to residents. Page 2 Out of 6 LPA Manuel Monter interviewed Community Life Director (CLD) Barbra Fleig. CLD stated, CLD stated she is aware of what occurred regarding R1’s transportation. CLD stated R1 was scheduled to go with another resident, on the transportation van. CLD stated they were going to ask the driver to take R1 to him/her appointment and wait for R1’s FM to arrive. CLD stated they ask the driver’s to accompany the residents inside or wait for their family members to watch over the residents. CLD stated they don’t leave residents there and just leave them unattended. CLD stated they informed FM ahead of time, they would arrive to the appointment and would wait for FM to arrive. CLD stated she spoke with R1’s FM and told him/her that the driver was going to be there. CLD stated FM didn’t want R1 to wait for her and canceled the appointment. CLD stated R1 wasn’t taken to his/her appointment by the facility because R1’s FM cancelled. CLD stated she called ahead of time, a few days in advanced, when speaking with the FM. On February 11, 2026, LPA Manuel Monter interviewed residents R5, R6, R19-R22. 6 out of 6 residents (R5, R6, R19-R22 ) stated they have used the facility transportation and have not had any issues. On February 9 & 17, LPA Manuel Monter interviewed staff S11 and S12. Staff S11 stated he/she is now are of or have knowledge regarding the facility’s transportation. S12 stated he/she is aware that resident who lived in the assisted living side, had issues with setting up their appointments, but didn’t have knowledge of the issues regarding this assisted living resident. S12 stated he/she was aware there was also issues regarding R1’s transportation, but stated he/she has no knowledge regarding this event. The Department reviewed Facility Transport Appointment form, regarding R1. The form states the transport request was submitted on April 9, 2025, for an appointment on April 21, 2025. Furthermore, the form states, R1 was scheduled to arrive at the appointment early, but driver was instructed to wait until his/her family member arrived. Community Life Director informed the family member prior to appointment day. R1's family member requested to cancel. R1's family member didn't want R1 to arrive early. The Department has completed the investigation of the above allegations. Based on interviews conducted and records review, the department has found that the above allegations were UNFOUNDED, meaning that the allegations were false, could not have happened and/or are without a reasonable basis. Page 3 Out of 6 Staff reported wrong incident information to family On July 7, 2025 the Department received a complaint alleging Staff reported wrong incident information to family. On July 14, 2025, Licensing Program Analyst Steve Chang conducted the initial complaint investigation visit. On January 20, 2026, Licensing Program Analyst Manuel Monter interviewed Witness W1. W1 stated he/she was informed about an incident that occurred at the facility with incorrect information. W1 stated he/she was called by an unknown staff, telling him/her that there was an altercation with 3 residents. RP stated he/she was initially told that R1 was holding a knife and was in an argument with another resident. RP stated he/she was contacted moments later informed that the information he/she received was incorrect and R1 was not holding the knife, but was verbally aggressive with another resident and the third resident was holding the knife. W1 stated he/she was called during the same day and informed about the mistake, within a few hours, but reiterated, he/she does not remember the exact time. W1 stated he/she believes this occurred in Spring 2025. On January 23, 2026, LPA Manuel Monter interviewed staff S2-S6. 5 Out of 5 staff (S2-S6) stated they are not aware of any incident where a resident in the memory care unit got a hold of a knife. On January 23, 2026, LPA Interviewed Assisted Living Director ALD Mayte Calderon. ALD stated she is not aware of any incident where a resident in the memory care unit got a hold of a knife. On February 5, 2026, LPA Manuel Monter interviewed Staff S7-S10. 4 Out of 4 staff (S7-S10) stated they are not aware of any incident where a resident in the memory care unit got a hold of a knife. On February 5, 2026, LPA Manuel Monter interviewed Memory Care Director Daleht Miranda, referred to as S1. S1 stated she does remember an incident where a resident got a hold of a knife. MCD stated she can’t remember the name of the resident. MCD stated she doesn’t’ remember. Page 4 Out of 6 On February 5, 2026, LPA Manuel Monter interviewed Community Life Director (CLD) Barbara Fleig. CLD stated she does remember an incident where a resident got a hold of a butter knife, in spring 2025. CLD mentioned possible names but does not remember. On February 11, 2026, LPA Manuel Monter interviewed Executive director (ED) Brenda Ritter. ED stated she isn’t aware of any instance where a resident in the memory care unit got a hold of a knife. ED stated if there was any issue like reporting the wrong information due to new information being discovered, then the facility would call back the responsible party and apologize for the mistake. On February 9 & 17, 2026, LPA interviewed staff S11 and S12. S11 stated regarding the incident with the knife: he/she doesn't remember the details. S11 stated he/she had just started her shift and had done his/her endorsement with the previous nurses. S11 stated sometime after, a care giver came to him/her and told him/her a resident had a knife and was arguing. S11 stated when he/she arrived there were already 3 care givers in between the residents separating them / redirecting them away from each other and the butter knife had been taken from the resident. S11 stated he/she cannot remember the details of the event but believes the residents involved could have been R23 and R24. S11 stated no one was injured from the incident. S11 stated once he/she was informed about the incident he/she or one of the managers did inform the residents responsible parties. S11 stated after their team had gotten the full story from all the care givers, they then realized that R1 was not involved in the incident, in which then the Responsible party of R1 was called and informed the same day. S12 sated he/she is aware of the incident that occurred in the memory care unit, regarding the butter knife. S12 stated there were 2 residents that were arguing with each other, then another resident also joined in the argument. S12 stated he/she thinks the resident with the knife was R24. S12 acknowledged that it was reported to R1’s FM, that R1 had the knife, which was inaccurate. S12 stated the facility later called R1's daughter to apologize for the incorrect information that was provided, due to additional information, after a debriefing was completed with the care givers who witnessed the event. S12 stated that he/she does not remember the details since he/she did not actually witness the event. Page 5 Out of 6 The Department reviewed resident R23 and R24's Progress notes. Progress note dated March 2, 2025 states staff S11, Heard commotion in the hallway. R23 was noted in the hallway in front of apartment door. Two residents were in the hallway being separated by 3 care givers. 1 care giver informed S11 that R24 had a knife and was trying to stab R23. S11 redirected R24 to his/her apartment. Although it is a fact that incorrect information was initially reported to R1’s responsible party, once the facility became aware of the error, they promptly contacted the responsible party to advise them of the mistake. Furthermore, based on interviews conducted, the inaccurate information was identified and the responsible party was provided with the correct information on the same day. The Department has completed the investigation of the above allegations. Based on interviews conducted and records review, the department has found that the above allegations were UNFOUNDED, meaning that the allegations were false, could not have happened and/or are without a reasonable basis. Page 6 Out of 6. On January 20, 2026, LPA Manuel Monter interviewed Witness W1. W1 stated the facility is supposed to do R1’s laundry once a week. W1 stated whenever he/she would visit, R1’s laundry would be over flowing. W1 stated the laundry would be overflowing within a couple days. W1 stated it was just constantly overflowing. W1 stated R1 should receive 2 showers per week, but W1 found many times that R1 did not receive 2 showers per week. W1 stated he/she would shower R1 many times. W1 stated he/she cannot provide the exact days when this occurred it has occurred multiple times during R1’s stay at the facility. On January 23, 2026, LPA Manuel Monter interviewed residents R14-R18. 4 Out of 5 residents (R14-R17) stated they do not need assistance with showers and have not had any issues regarding their showering needs. 4 Out of 5 residents (R14-R17) stated they have not had any issues regarding his/her laundry service. R18 was unable to provide relevant information due to neurocognitive disorder. On January 23, 2026, LPA Manuel Monter interviewed staff S2-S6. 5 Out of 5 staff (S2-S6) stated they is not aware of any instance where a resident was neglected their shower or a residents laundry service needs that were neglected. On January 23, 2026, LPA Manuel Monter interviewed Assisted Living Director (ALD) Mayte Calderon. ALD stated residents showers are done via schedule. ALD stated if a resident has an accident, staff will clean up that resident. ALD stated she is not aware or hasn’t seen any or heard about a resident being neglected their shower. ALD stated residents laundry is done at least once a week, via shower schedule. ALD stated she isn’t aware of any instance of a residents laundry service needs being neglected. On January 23, 2026, LPA Manuel Monter toured the memory care unit inside and out. LPA toured the following bedrooms: 234, 236, 238, 240 A+B, 242, 244, 246, 247, 249, 248, 250, 253, 252, 254, 257, 256, 259 A+B, 258, 222, 221 A+B, 218, 220, 216 A+B, 214, 212, 210, 209, 208, 207, 205, 206, 203, 200 A+B, 201 A+B. During the tour of the memory care unit, LPA did not observe any areas as unclean, unhygienic or disorderly. LPA did not observe any residents in a disheveled state or with soiled clothing. On February 5, 2026, LPA interviewed Maintenance Director Mithun Prasad (MD). MD stated the laundry is done at least once a week or more if requested. MD stated if the resident has an accident, then laundry will be done as well. MD stated there have not been any issues the facility washing machine or dryer. MD stated each floor of the facility has 3 washing machines and dryers. MD stated the basement has a commercial grade washer and dryer machines as well. MD stated during his rounds he hasn’t observed residents laundry services / needs being neglected. MD stated he has not observed over a weeks worth of laundry pilled in residents bedrooms. MD stated he hasn’t seen any residents who have been neglected their showering needs. On February 5, 2026, LPA Manuel Monter interviewed Memory Care Director Daleht Miranda, referred to as S1. S1 stated residents laundry is clean via the laundry schedule. S1 stated the care givers do the laundry. S1 stated they wash the residents close at least weekly or more if needed. S1 stated there has never been a time when she observed residents laundry needs neglected or resident laundry pilling up, resulting in more than a weeks worth of dirty laundry. S1 stated residents are showered via shower schedule. S1 stated they follow the shower schedule. S1 stated some residents might refuse, but they will try with a different person, and make sure the resident received their shower. S1 stated even if a resident refuses, that day, staff will give that refusing resident a sponge bath. S1 stated she is not aware of any instance where a resident was not given or neglected their shower. On February 5, 2026, LPA Manuel Monter interviewed Community Life Director (CLD) Barbra Fleig. CLD stated there has never been a time when she observed residents laundry needs neglected or resident laundry pilling up, resulting in more than a weeks worth of dirty laundry. CLD stated he/she is not aware of any instance where a resident was not given or neglected their shower. On February 5 and 9, 2026, LPA Manuel Monter interviewed staff S7-S11. 3 Out of 5 staff (S7, S9, S10 ) stated they is not aware of any instance where a resident was neglected their shower or a residents laundry service needs that were neglected. S8 stated there were times when the residents laundry needs were being neglected. S8 stated this also occurred in the June-August 2025 time period. S8 stated he/she can’t say a specific example but stated he/she remembers that during that time period there was a lot of difficulty regarding residents laundry. S8 stated the care givers in the morning shift would say the next shift will do it, and would neglect the laundry. S8 stated this was addressed some time last year. S8 stated he/she is not aware of any instance where a resident was not given or neglected their shower. S11 stated he/she did not observe any instance where residents laundry needs were being neglected. S11 stated he/she did not shower any residents during his/her shift. On February 11, 2026, LPA Manuel Monter interviewed Residents R5, R6, R19-R22. 2 Out of 6 residents (R5, R6) stated they receive laundry services and have not had any issues. R6 stated he/she does need assistance with showers and has not had any issues with the assistance the facility is providing regarding showers. 5 Out of 6 residents (R5, R19 R20, R21, R22) stated they do not need assistance with showers and have not had any issues regarding his/her showering needs. 4 Out of 6 residents (R19 R20, R21, R22) stated they do their own laundry. On February 11, 2026, LPA Manuel Monter interviewed Executive Director (ED) Brenda Ritter. ED stated she heard there was some miscommunication on who washes what back in the summer of 2025. ED stated she isn’t privy to the details since she wasn’t there. ED stated during her time at the facility, there hasn't been any issues regarding laundry services being neglected. ED stated she isn’t aware of any instance where staff did not provide residents with their showers. ED stated she isn’t aware of a resident being neglected their shower for over a week. On February 17, 2026, LPA interviewed staff S12. S12 stated the care givers do the laundry for the residents at least once a week. S12 stated he/she never saw residents laundry pile up more than a weeks worth of laundry. S12 stated they actually washed the residents cloths more than once a week because memory care residents go thru a lot of clothing. S12 stated he/she is not aware of any instance where a resident wasn’t assisted with their showers. S12 stated one of the residents family's members alleged their parent was not being bathed. S12 stated he/she did go ask the care giver that was assigned to shower that resident that day, but the staff member stated that he/she didn't do it due to a refusal. S12 stated the resident’s family was convinced the staff were not even attempting to shower her mother. S12 stated he/she did provide his/her contact information to the family member and encouraged him/her to contact S12 if he/she suspected a shower wasn't given to instruct staff to shower the resident the moment its brought up. S12 stated they did have trouble at the time with residents who refused showers, but they would do their best to try different methods to shower the residents. S12 reiterated, even though there were residents who would refuse, those residents would eventually be showered and weren't neglected. Based on investigation, records reviewed, and interviews conducted, the Department found that the above allegations are UNSUBSTANTIATED. An unsubstantiated finding indicates that although the allegation may have happened or is valid, there is not a preponderance of evidence to prove that the allegations did or did not occur.the state’s words, verbatim · CDSS document, Feb 20, 2026 · control 26-AS-20250707122429

The state marks this report as 15 pages; the online copy we transcribed has 14. You can request the full file from the county licensing office.

Type of visit: Required - 1 Year

This report was amended to capture LPA signature and facility representative signature. Licensing Program Analyst (LPA) Marcela Yanez conducted an unannounced Required 1 Year visit and met with Kellie Shearer, Executive Director (ED) and Memory Care Director Daleht Miranda. LPA announced the purpose of the visit. LPAs toured Assisted Living building with Memory care Director inside and out, which includse upstairs and downstairs. LPA randomly inspected the following, but not limited to resident bedrooms: 449, 522, 622,348, LPA randomly tested 4 resident bedrooms water with thermometer and measured range from 110.8 to 112.8 degrees F. LPAs also inspected the dining area and kitchen. LPAs observed the kitchen area Refrigerator temperature measured at 43 degrees F and Walk in Freezer at -2 degrees F. LPAs observed perishable food supply of at least two days and a non-perishable food supply of at least seven days. No obstructions were noted during tour. LPA toured three resident bedrooms in Memory Care . Each bedroom had available bedding and clothing storage areas as well as functioning lights. LPA randomly inspected the following, but not limited to resident bedrooms: 205, 206, 203. LPA randomly tested 3 bedrooms water temperature with thermometer and measured to range from 110-112 degrees F. LPA tested delayed egress doors which activated auditory sound when pressed. Page 1 of 2 This report was amended to capture LPA signature and Facility Representative signature Page 2 of 2 During tour LPA observed an activity room with puzzles, reading books, magazines and a cafe. The facility has a screening room, exercise room, a dog park and a hair salon. The facility has a laundry room on each of the floors. The facility has a printed weekly and monthly activity schedule in random locations and on a television screen when you enter the elevator on each of the 6 floors. LPA toured the outside area and found the exits to be clear of obstructions. LPA observed fire extinguisher was last serviced on 05/27/25. LPA reviewed Fire and Earthquake log. The facility last conducted Fire drill on 10/09/25 and Earthquake drill on 09/24/25. The facility has a fire sprinkler system and it was last serviced on 10/10/25. LPA reviewed resident records for 10 residents. Medication Technician and LPA reviewed Centrally Stored Medication Record for 5 residents. LPA reviewed 5 staff records. No deficiency were cited as per California Code of Regulations Title 22. This report was reviewed with Kellie Shearer and a copy of this report was provided End of reportthe state’s words, verbatim · CDSS document, Nov 19, 2025

Type of visit: Case Management - Incident

Licensing Program Analyst (LPA) Maria (Mita) Partoza, conducted an unannounced case management visit for the incident that was reported on 10/16/2025. LPA met with Executive Director (ED) Kellie Shearer and stated the purpose of the visit. During the visit, LPA gathered information such as but not limited to LIC 602 (Physician's report), appraisal needs and services plan, staff training logs was emailed to LPA and LIC 500. LPA conducted an interview with ED and with resident. Based on this information it has been determined that the case management needs further investigation. No deficiencies were cited during today's visit based on California Code of Regulations (CCR) Title 22. An exit interview was conducted with ED Kellie Shearer and a copy of the report was provided.the state’s words, verbatim · CDSS document, Nov 5, 2025

Type of visit: Case Management - Incident

Licensing Program Analyst (LPA) Marcella Tarin arrived unannounced to conduct a Case Management-Incident visit regarding an SOC 341 submitted to the Department on 7/18/2025. LPA met with Executive Director (ED) Kellie Shearer. LPA stated the purpose of the visit. On 7/18/2025 the Department received an SOC 341 for Resident R1. During visit, LPA interviewed 2 staff, and requested documentation to include but not limited to service plans, physician's reports, and emergency contact information. ED states the facility will submit an LIC624 Incident Report to the Department by 7/23/2025. No deficiencies were cited during today's visit per California Code of Regulation Title 22. An exit interview was conducted with ED and a copy of this report was provided.the state’s words, verbatim · CDSS document, Jul 22, 2025

Type of visit: Prelicensing

THIS IS AN AMENDED REPORT. Licensing Program Analysts (LPAs) Christine Dolores and Santino Fortes arrived announced to conduct the facility's pre-licensing inspection. LPAs met with Brenda Ritter (Regional Director of Operations) and Carol Pickard (Senior Executive Director). The facility's fire clearance is approved for 205 capacity in which 193 may be non-ambulatory and 12 may be bedridden. All rooms are approved for non-ambulatory / bedridden residents. The facility is connected to a commercial building and Gallery Cafe (located near the first-floor entrance) that is not part of the facility's license. According to the applicant, the café may be opened in year 2025 and the residents may have access to the Gallery café which is not part of the licensee or excluded from the license. Between the community and Gallery café can be accessed through a door (passageway) by a using a key card on the wall to enter both ways from inside the Café and in the facility. The applicant states the Gallery Café may or may not be employees of the facility. The applicant states that if they are employees of the facility, they will ensure compliance with Title 22. The applicant was informed that if they are not part of the facility’s employees that the staff who work in the Gallery Café should not be allowed inside the premises of the facility unless the individual is escorted or supervised by the facility staff. LPAs toured the facility with Brenda and Carol to include the exterior, underground garage, first, second, third, fourth, fifth, and sixth floor. All indoor and outdoor passageways and stairwells were free and clear of obstruction. There are 2 courtyard emergency exits doors that are able to freely open wherein they do not contain any locks that prevent the doors from opening. Stairwell #1 and #2 observed with an evacuation chair located on the fourth and sixth floor. Facility temperature maintained between 69 - 73 degrees F. Elevators observed to be in working condition. There is no swimming pool or other bodies of water observed. Adequate lighting are present in the hallways and common areas. Pull cord devices that includes an emergency call button observed throughout the facility were randomly tested in each floors and are operational. Applicant stated that resident calls are captured through a staff radio (pagers) and a list of calls are registered via PALCare Software. SEE LIC809-C. The first floor contains a concierge desk, office rooms, activity room, screening room, salon, gym, kitchen and dining room. Restrooms on the first floor contains pull cords, hand-washing signs, and an ADA compliant door button. Posters observed to include if you see something say something, ombudsman, resident rights, resident council, and theft and loss policy. Kitchen equipped with plates, bowls, utensils and cups. Refrigerator temperature maintained at 45 degrees F. Freezer temperature maintained at 0 degrees F. Fire extinguisher in the kitchen last serviced on 10/01/2024. The second floor will be used for the memory care unit. The second floor is equipped with 2 functional delayed egress doors approved by the San Jose Fire Department per STD650 Fire Clearance. There are 2 elevator rooms located in different areas of the memory care unit. Each elevator room contains a door in between the elevator room and hallway of the memory care unit. The doors contain a key fob to access the elevator room, which staff will be provided the access to. Resident bedrooms equipped with adequate lighting, a personal thermostat, and personal bathroom. All bathroom shower contains a shower chair, non-slip floors, grabs bars, and locked drawers / cabinets. Bathroom hot water temperature in RM 223 maintained at 109.2 degrees F. The kitchen refrigerator temperature maintained at 36 degrees F and freezer temperature maintained at -5 degrees F. Food warmer observed in the kitchen area. The dining room observed with plates, bowls, utensils, and cups. Medication room, housekeeping storage, and laundry room observed with a locked door. First aid kit observed in the medication room. Medication room is not yet supplied with the medication carts which will contain the sharps container. Windows and window screens observed in good repair. According to the applicant the third, fourth, fifth, and sixth floors is the assisted living units (AL unit). Applicant stated that future residents that will be admitted, in the AL unit, are a combination of residents who are independent who only require minimal assistance with ADLs. Each floor has centrally stored locked medication room and laundry room. Third floor’s hot water temperature measured at 120 degrees F. RM 407 hot water temperature maintained at 122.7 degrees F. During visit, the hot water temperature was adjusted and observed at 110.4 degrees F. RM 522 hot water temperature maintained at 118.2 degrees F. RM 651 hot water temperature maintained at 111.0 degrees F. Facility has an emergency disaster plan and infection control plan. Flashlights observed in some of the fire extinguisher boxes. Facility is equipped with a back-up generator. COMP III is waived as applicant has reviewed COMP III in other Watermark Facilities in California. Pre-Licensing is complete and this facility has no deficiencies. LPA observed the facility is ready to be licensed. However, this report will be submitted to the Central Application Bureau (CAB) and a final review of the application will be conducted. This facility is not yet licensed and is subject to final approval by CAB. Additional requirements may still be required. This report was reviewed with Brenda Ritter, Carol Pickard, and Mike Hughes and a copy of the report was provided.the state’s words, verbatim · CDSS document, Nov 6, 2024

Type of visit: Office

Facility Type: Residential Care Facility for the Elderly Application Type: Initial Capacity: 205 Census (if any clients in care): 0 COMP II Participants: CAROL PICKARD, MICHAEL HUGHES Interview Method: Telephone interview On September 25, 2024, applicant/administrator participated in COMP II. Identification of the applicant and administrator was verified through interview questions based on photo ID and other identifying personal information. During COMP II, applicant and administrator confirmed the understanding of the California Code Title 22 Regulations. Signed LIC 809 with copy of photo ID have been obtained. During COMP II, CAB analyst confirmed Applicant/Administrator’s understanding of following areas: 1. Facility operation: License type, client/resident populations, and program 2. Admission Policies 3. Staffing requirements & Training 4. Restricted/Prohibited Health Conditions 5. General provisions 6. Emergency Preparedness 7. Complaints & Reporting 8. Pre-licensing readinessthe state’s words, verbatim · CDSS document, Sep 25, 2024